Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Positron emission tomography (PET) is the most powerful molecular imaging technique currently available for clinical use. Because deranged tumour metabolism is a common finding in many malignancies, PET is frequently used for tissue characterisation, staging and therapy control. Four previous consensus studies in Germany, performed up to 1997, have established indications for fluorine-18 fluoro-2-deoxy-D-glucose (FDG) PET in oncology, neurology and cardiology. More than 10,000 references on FDG-PET have been published in the meantime, mostly on oncological issues. Therefore, it was the aim of the present paper to provide an update on the clinical use of FDG-PET in oncology. For this purpose a systematic literature search was performed in all common medical literature databases. All hits were manually checked and abstracts, case reports, technically oriented papers and reviews were excluded from analysis. A questionnaire comprising 24 items was developed for standardised quality assessment according to evidence-based medicine (EBM) criteria. We selected 533 papers for further review by an interdisciplinary panel of 58 experts from oncology, radiology and nuclear medicine. Clinical use was judged according to the following grading scheme: 1a, established clinical use; 1b, clinical use probable; 2, useful in individual cases; 3, not yet assessable owing to missing or incomplete data; 4, clinical use rare (either as inferred from theoretical considerations or as demonstrated by published studies). Of the 533 papers selected, 122 references with 7,092 documented patients fulfilled the EBM criteria for detailed review. The results of these studies were tabulated and are available at www.nucmed-ulm.de. Clinical indications (grade 1a or 1b) were established for differentiating benign from malignant lesions in pulmonary nodules, pancreatic masses and residual masses after chemotherapy in malignant lymphoma. Staging was improved by FDG-PET in oesophageal cancer, breast cancer, head and neck cancer, lung cancer, malignant lymphoma and malignant melanoma. Effectiveness of radio- and/or chemotherapy could be better controlled in Hodgkin's disease and high-grade non-Hodgkin's lymphoma. Restaging was improved in relapsing thyroid cancer, colorectal cancer, head and neck cancer, lung cancer and malignant melanoma. In summary, the efficiency of FDG-PET was studied in several thousand patients with malignant tumours and was found to be well documented in the international high-quality peer-reviewed literature. There are clear-cut clinical indications for FDG-PET in diagnosis, staging and therapy control, and the technique can help to improve the management of many patients with cancer.
 ...
PMID:FDG-PET for clinical use. Results of the 3rd German Interdisciplinary Consensus Conference, "Onko-PET III", 21 July and 19 September 2000. 1170 15

The occurrence of a sarcoidosis associated with Hodgkin's disease is an infrequent but well-described event. Moreover it has been described for many decades that some malignancies may present with simultaneous granulomatous manifestations named sarcoid-like reactions. To differentiate sarcoidosis from the sarcoid-like reactions is not an easy step in the final diagnosis. No author in the past has included the use of 2-deoxy-2[18F]fluoro-D-glucose positron emission tomography (FDG-PET) in order to help in this differentiation. We report two patients with Hodgkin's disease complicated with a typical form of sarcoidosis and with diffuse sarcoid-like reactions. We discuss the use of FDG-PET as a tool in the making of the final diagnosis and the difficulties associated with this technique in the interpretation of different hypermetabolic tissues.
 ...
PMID:Sarcoidosis and sarcoid-like reaction following Hodgkin's disease. Report of two cases. 1449 56

Positron emission tomography (PET) is a novel functional imaging technique that provides several inherent advantages over conventional nuclear scintigraphy. Several studies have suggested a role for PET using the positron emitter fluorine-18 in the diagnosis and follow-up of patients with lymphoma. This review summarizes the existing data evaluating the role of 2-fluoro-2-deoxy-D-glucose (FDG)-PET in both the staging and follow-up of patients with lymphoma. Most studies of PET involve patients with either Hodgkin's disease or diffuse large B-cell non-Hodgkin's lymphoma. PET detects more disease sites above and below the diaphragm on staging of lymphoma than gallium scintigraphy and may have particular utility in the evaluation of the spleen. Moreover, persistently positive PET scans during and after chemotherapy appear to have a high sensitivity for predicting subsequent relapse. A negative PET scan at the end of therapy provides very favorable prognostic information. Persistently positive PET scans at the end of therapy warrant close follow-up or additional diagnostic procedures, since some of those patients may remain in prolonged remission. Clearly, additional studies, including prospective blinded trials and cost-effectiveness analyses, are warranted to determine which subsets of patients with lymphoma ultimately will benefit from this modality.
 ...
PMID:PET scans in the staging of lymphoma: current status. 1453 Apr 96

The usefulness of F-18 2'-deoxy-2-fluoro-D-glucose (FDG) positron emission tomography (PET) has been well established for lymphoma staging. Although involvement of the pancreas occurs in more than one third of patients with non-Hodgkin lymphoma, primary lymphoma of the pancreas accounts for less than 1% of extranodal non-Hodgkin lymphomas. Because patients with primary pancreatic lymphoma require a different therapeutic approach and have a better prognosis than those with pancreatic adenocarcinoma, the accurate diagnosis is important. However, conventional imaging modalities cannot differentiate between adenocarcinoma and other less common neoplasms such as lymphoma. We report a 67-year-old man who had a primary pancreatic lymphoma in which FDG PET imaging revealed round, intense FDG uptake in the center of the midabdomen.
 ...
PMID:F-18 FDG positron emission tomography findings in primary pancreatic lymphoma. 1531 Nov 30

The role of 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in combination with computed tomography (CT) in the evaluation of pelvic malignancies has been rapidly growing in recent years. FDG PET has proved to be valuable in the evaluation of a variety of pelvic malignancies, including colorectal cancer, uterine cervical cancer, ovarian cancer, endometrial cancer, and non-Hodgkin lymphoma. However, a number of pitfalls are commonly encountered at FDG PET, including normal physiologic activity in bowel, ovaries, endometrium, and blood vessels and focal retained activity in ureters, bladder diverticula, pelvic kidneys, and urinary diversions. The use of an in-line FDG PET-CT system, with special attention given to proper patient preparation and scanning protocol, often provides valuable information to help localize and define disease and avoid potential diagnostic pitfalls.
 ...
PMID:Imaging of pelvic malignancies with in-line FDG PET-CT: case examples and common pitfalls of FDG PET. 1600 22

Risk-adapted lymphoma treatment requires early and accurate assessment of prognosis. This investigation prospectively assessed the value of positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose (FDG-PET) after two cycles of chemotherapy for prediction of progression-free survival (PFS) and overall survival (OS) in Hodgkin lymphoma (HL). Seventy-seven consecutive, newly diagnosed patients underwent FDG-PET at staging, after two and four cycles of chemotherapy, and after completion of chemotherapy. Median follow-up was 23 months. After two cycles of chemotherapy, 61 patients had negative FDG-PET scans and 16 patients had positive scans. Eleven of 16 FDG-PET-positive patients progressed and 2 died. Three of 61 FDG-PET-negative patients progressed; all were alive at latest follow-up. Survival analyses showed strong associations between early FDG-PET after two cycles and PFS (P < .001) and OS (P < .01). For prediction of PFS, interim FDG-PET was as accurate after two cycles as later during treatment and superior to computerized tomography (CT) at all times. In regression analyses, early interim FDG-PET was stronger than established prognostic factors. Other significant prognostic factors were stage and extranodal disease. Early interim FDG-PET is a strong and independent predictor of PFS in HL. A positive early interim FDG-PET is highly predictive of progression in patients with advanced-stage or extranodal disease.
 ...
PMID:FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma. 1615 Sep 44

Positron emission tomography using 2-[18F]fluoro-2-deoxy-D-glucose (FDG-PET) enables quantitative analysis of metabolic activity. This study investigated standardized uptake value (SUV) levels in the different histopathological subtypes of Hodgkin lymphoma (HL). Sixty patients with newly diagnosed HL underwent staging FDG-PET/CT after lymph node biopsy. Maximum SUV in each patient (SUV(max/total)) and in each affected region or organ (SUV(max)) were recorded. Mean SUV(max/total) was 9.3 g/ml in seven nodular lymphocyte predominance (NLP) patients, 16.3 g/ml in 38 nodular sclerosis (NS) patients, 20.8 g/ml in 11 mixed cellularity (MC) patients, and 19.5 g/ml in four patients with unclassified classical HL (CHL-NOS), (ANOVA, p = 0.011). Out of 780 sites (600 lymph node regions plus 180 organs), 208 sites were found to be affected with HL. Mean SUV(max) was 8.3 g/ml in the 12 sites with NLP, 11.2 g/ml in the 147 sites affected with NS, 14.6 g/ml in the 36 sites with MC, and 13.1 g/ml in the 13 sites with CHL-NOS (ANOVA, p = 0.002). There is a significant difference in FDG/glucose uptake between the different histopathological subtypes of HL.
 ...
PMID:Different histopathological subtypes of Hodgkin lymphoma show significantly different levels of FDG uptake. 1672 53

The identification of refractory or nonresponding tumors at an early period during therapy may lead to abbreviation of the current therapy regimen or timely institution of an alternative therapy protocol. Nevertheless, evaluation of treatment response is consequential clinically if the tumor potentially is curable and if effective treatment alternatives exist, so that change in treatment ultimately may increase the probability of response and survival. Hodgkin disease (HD) and diffuse large cell lymphoma (LCL) fit in this model well. However, a subset of patients is either refractory to first-line treatment or develops recurrent disease after an initial remission. Improvements in the treatment of these diseases rely not only on new therapy modalities and accurate assessment of disease extent but also on the assessment of disease extent and on timely and accurate therapy response to enable a more effective management plan. Although the International Prognostic Score for HD and International Prognostic Index for LCL have proved valuable for the stratification of patients in clinical trials, there is variability in outcome within the individual risk groups. Recently, positron emission tomography using (18)F-labeled fluoro-2-deoxy-D-glucose (FDG-PET) imaging has been suggested as a sensitive and relatively more specific means to reflect tumor biologic changes after therapy. With increasingly compelling evidence, early FDG-PET provides a reliable means to assess tumor response accurately that may lead to better management with an effective therapeutic approach.
 ...
PMID:Early 18F-labeled fluoro-2-deoxy-D-glucose positron emission tomography scanning in the lymphomas: changing the paradigms of treatments? 1693 31

Therapy of Hodgkin disease (HD) is designed to prolong progression-free survival and minimize toxicity. The best regimen to achieve this has not yet been defined. A total of 108 patients with newly diagnosed HD and adverse prognostic factors were prospectively studied between 1999 and 2004. They were assigned to therapy according to defined risk stratification. Patients were defined depending on the International Prognostic Score (IPS). Those with IPS of 3 or higher received 2 cycles of escalated therapy, including bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP [EB]). All others received 2 cycles of standard BEACOPP (SB). Subsequent therapy was prospectively assigned following 2 cycles according to results of early interim 67Ga or positron emission tomography/computed tomography (PET/CT). Following a positive interim scan, 4 cycles of EB were administered, whereas 4 cycles of SB were given to patients with a negative scan. The complete remission rate, the 5-year event-free survival (EFS), and overall survival (OS) rates were 97%, 85% and 90%, respectively. Relapse or progression occurred in 27% of patients with interim positive PET/CT versus 2.3% of negative scans (P<.02). Early interim fluorine-18 2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT is a useful tool for adjustment of chemotherapy on an individual basis. Similar EFS and OS rates were observed for patients in both risk groups.
 ...
PMID:Risk-adapted BEACOPP regimen can reduce the cumulative dose of chemotherapy for standard and high-risk Hodgkin lymphoma with no impairment of outcome. 1701 56

Role of Positron Emission Tomography (PET) with F-18-2-fluoro-2-deoxy-D-glucose (FDG) in staging of Hodgkin disease is well established despite several controversies. We report a Stage III Hodgkin lymphoma patient with false positive FDG-PET/CT results. Seven-year-old male with Hodgkin lymphoma was in remission at end of chemotherapy. At third and fourth month of postchemotherapy follow-up, increased Gallium uptake and positive FDG-PET/CT in right lower quadrant of abdomen was observed. Open biopsy revealed lymphoid hyperplasia. He has been followed for 21 months without any evidence of disease. Despite its documented benefit, we believe that results of FDG-PET/CT should be interpreted with great caution in order to avoid unnecessary interventions.
 ...
PMID:False positivity of FDG-PET/CT in a child with Hodgkin disease. 1741 91


<< Previous 1 2 3 4 5 6 7 Next >>